Big boys don't cry: Depression and men

Men are a numerical minority group receiving a diagnosis of, and treatment for, depression. However, community surveys of men and of their mental health issues (e.g. suicide and alcoholism) have led some to suggest that many more men have depression than are currently seen in healthcare services. This article explores current approaches to men and depression, which draw on theories of sex differences, gender roles and hegemonic masculinity. The sex differences approach has the potential to provide diagnostic tools for (male) depression; gender role theory could be used to redesign health services so that they target individuals who have a masculine, problem-focused coping style; and hegemonic masculinity highlights how gender is enacted through depression and that men’s depression may be visible in abusive, aggressive and violent practices. Depression in men is receiving growing recognition, and recent policy changes in the UK may mean that health services are obliged to incorporate services that meet the needs of men with depression

Patients’ Experiences of penile Cancer

Penile cancer is a rare but destructive disease in Western populations. In the United Kingdom, penile cancer accounts for <1% of all new cases of cancer and <1% of deaths due to cancer every year (see Table 1). [Table 1] Surgical removal of the cancer is the primary form of treatment. This involves surgical excision of the primary tumour and of involved inguinal lymph nodes. Chemotherapy and radiotherapy are rarely helpful, with their use restricted either to adjuvant use or for palliative treatment of extensive disease. In treating the primary tumour, the standard of care is to provide a surgical cure (ie, excising the tumour and a margin of normal penile tissue) while maintaining the function of the penis. The traditional view was that at least a 2-cm margin of normal tissue should be removed, but recent publications suggest that more conservative surgery may be safe [1], and [2]. The advantage of such organ-preserving surgery is intuitively advantageous to the patient in that penile function can be better preserved, but the evidence to support this view is limited at present

People in public health. Expert hearings: a summary report

People in Public Health is a national study that is looking at how volunteers and lay workers are involved in improving health in their communities. The study’s main aim is to improve understanding of how to support lay people in their many and varied public health roles. In June 2008, three expert hearings were held so that the research team could listen to the views of people with specialist knowledge or practical experience of working in this way. Fifteen experts were invited from around the country to talk about how and why lay people get involved in public health, why the work they do is important and what the main barriers are. Our experts included lay people active in their communities, university researchers, people working in the health service (NHS), local government and the voluntary sector. While some talked about their experience of specific projects, others made more general points about services and support. All the expert hearings were held in public and there were opportunities for discussion

Conducting interviews about penile cancer: A patient-conducted-interview study

Objectives: Penile cancer is a rare but destructive condition. It has been found to be detrimental to body image, general health and sexual functioning, while increasing anxiety and social problems. The UK now manages penile cancer through specialist multi-disciplinary teams that see at least 25 new patients a year. There is a need to understand patients’ experiences so that treatment can be improved. The aim of this research is to allow patients to participate in the development of a nationwide interview study. Methods: A one-day participative workshop where a range of men diagnosed with penile cancer design and conduct audio and video interviews exploring experiences of treatment within the group. Results: Key themes included the rehabilitation of urinary functioning and strategies for coping with the physical and social impact of treatment. Conclusions: The findings emphasise the importance of day-to-day practicalities for men treated for penile cancer, which can form the basis for larger studies about how to better understand and manage their treatment

Psychology, men and cancer

A disease of the anatomical or social body, cancer raises fears about the uncontrollable division and multiplication of some abnormality that will lead ultimately to the destruction of those very conditions that make possible our lives. Cancer incidence and mortality rates are higher in men than women, raising questions about the roles for psychologists in relation to gender and cancer. Psychologists are wont to question the division of population level statistics by sex rather than other, such as behavioural, categories. Conceptual distinctions between biological sex and psychosocial gender are taught early in the psychology curriculum, but cancer of the breast questions the easy separation of the biological bod

The Bradford & Airedale Health of Men initiative: a study of its effectiveness in engaging with men

The Health of Men (HoM) network received funding from the Big Lottery Fund in 2003 to establish a five year programme of dedicated work with men and boys. This enabled a team of practitioners to be creative and to build upon their existing skills to generate models of working with those men in the community that are usually seen as hard to reach. The research which has accompanied of the work of team has explored why men use these new services and has demonstrated the following: • Men do care about their health • Men are willing and able to engage with their health when services are tailored to their needs • Men from different culture groups and socio-economic backgrounds who are normally seen as hard to reach were accessed. • A model encompassing a dedicated team working with men is worthy of further development Much has been learnt from this project that has great relevance to the local Primary Care Trust (PCT), but has also proved a great source of information for the development of services to men on a Regional, National and International level

The gender and access to health services study: final report

Men and women frequently think and behave differently. To observe this is not to suggest anything so absurdly simple as that there are only male and female ways of being; behaviours and thought processes vary according to numerous other factors besides gender. That this is very generally the case however, does mean that there are broad - and often broadly predictable - differences in the way men and women engage with the world. Most commercial organisations understand this very well and plan accordingly. Many public authorities recognise it too and take these differences into account when developing and providing services. For historical reasons however the NHS has rarely done so. It is widely known that there are differences between men and women in the incidence and prevalence of most health conditions. Sometimes there are clear biological reasons for these differences but often there are not. Where biology offers little or no enlightenment, other questions need to be asked: · Do men and women behave in ways that predispose them to particular health conditions to different degrees? · Do men and women use health services with different degrees of effectiveness? · Do men and women receive differerent kinds of service from the NHS? The answer is – yes, these things happen frequently. This is sometimes to the disadvantage of one sex and sometimes to the disadvantage of the other. Sometimes it is to the disadvantage of both. And when these things happen, health outcomes are often affected. This report looks at the reasons why gender is such an important and fundamental determinant of health status and considers the ways in which gender inequalities can be tackled within the present legislative and policy framework. It also brings together the knowledge and evidence in relation to six specific areas of health concerns

Subjectivity, not personality: combining psychoanalysis and discourse analysis

Mainstream psychology can often be criticized for turning the liberal concerns of psychologists into conservative practices focusing on the individual. In the United Kingdom, the discursive turn in social psychology has been marked by an audacious body of work critical of cognitive attempts to theorize the social. A particular psycho-discursive strand has emerged, which combines discourse analysis and psychoanalytic theory in an attempt to change both the subject of, and the subjectivity (re)produced by, mainstream psychology. This paper reviews three different psycho-discursive approaches: (i) Hollway and Jefferson's Free Association Narrative Interview method; (ii) Billig's Psychoanalytic Discursive Psychology; (iii) Parker's Lacanian excursions into social psychology. In these psycho-discursive approaches, ‘subjectivity’ replaces personality as the key theoretical construct where the social forms part of who we are and these approaches seem to offer social psychologists the theoretical tools to start to appreciate how individual personality and social context are intimately connected